小剂量维替泊芬联合光动力疗法治疗迁延性CSC

Pilot study on photodynamic therapy with low dose verteporfin for chronic central serous chorioretinopathy

目的：观察1／3剂量维替泊芬光动力疗法治疗迁延性中心性浆液性脉络膜视网膜病变（central serous chorioretinopathy，CSC）的疗效。方法：反复发作的CSC患者23例（23眼），经眼底检查、眼底荧光血管造影及吲哚菁绿造影检查，接受1／3剂量维替泊芬的治疗。维替泊芬注入8min后，在FFA的引导下激光照射30s，术后随访6～12（平均9．2）mo，随访期间进行最佳矫正视力、FFA检查，对检查结果进行分析，并观察治疗的安全性。结果：在23眼中，视力均有不同程度提高，1mo后视物变形改善有21眼，6mo后视物变形均有好转，FFA检查中，1mo后活动性渗漏消失的有20眼，3mo后全部消失。OCT检查黄斑部水肿均在3mo后消失。结论：1／3剂量维替泊芬治疗迁延性CSC具有较好的疗效，但是该治疗方法的长期有效性有待于进一步的对照研究来证实。

AIM ： To observe the therapeutic effect of photodynamic therapy with one third dose verteporfin for chronic central serous chorioretinopathy. METHODS： Twenty-three eyes of 23 patients with symptomatic chronic central serous chorioretinopathy underwent PDT using one third dose verteporfin after the examination of fundus, FFA and OCT. Verteporfin was infused over 8 minutes followed by laser application 30 seconds. Postoperatively, all patients were followed up for 6-12 months, meanly 9.2 months. During follow-up, examinations included visual acuity measurement, fundus examination, fluorescein and OCT. The outcome of these examinations were analyzed and the security of the treatment was observed. RESULTS： All patients＇ vision acuity improved in different degree. The symptom of motophopia improved in 21 eyes and disappeared after 6 months. In FFA examination, the leakage point disappeared in 20 eyes and all disappeared after 3 months. The edema of macular disappeared in all patients after 3 months. CONCLUSION： Photodynamic therapy with one third dose verteporfin is beneficial treatment for chronic central serous chorioretinopathy, but further controlled study is warranted to demonstrate the efficacy of long time in the treatment.